C-TRU major research projects

On this page, view a list of project-specific staff or explore both our ongoing and completed projects:

Ongoing projects

1. RESTART project – trauma-focused therapies for people at risk of developing psychosis
2. The STAR trial – evaluating whether trauma-focused therapies are helpful for people who experience psychosis
3. The ChUSE trial– increasing choice in NHS services for children and young people with unusual sensory experiences.
4. CONNECT Project – Can we use digital devices to predict if someone will experience a relapse in psychosis?
5. MIND-P project – How useful is group mindfulness therapy for individuals experiencing paranoid thoughts?
6. Soteria project – a review of the implementation of the Soteria approach: a non-psychiatric alternative to interventions for unusual experiences 
7. Older adult trauma study – An estimation of the prevalence of Post-Traumatic Stress Disorder (PTSD) symptoms in older adults supported by community mental health services 

Completed projects

1. IPPACT project – predicting severe mental health difficulties in people showing early signs of psychosis
2. COVID-19 Resilience (Co-Re) project – psychological impact of COVID-19 on NHS clinical staff
3. Resilience Hubs Evaluation project – new NHS mental health services to support COVID-19 key workers
4. The Sexual Violence Priority Setting Partnership – research priorities of sexual violence and abuse survivors
5. The EASE trial – exploring trauma-focused therapies for psychosis
6. i-Minds – digital interventions for survivors of online childhood sexual abuse
7. TULIPS project – psychological therapy on mental health inpatient wards
8. Staff TIME Project – Time to talk about staff trauma in inpatient mental health

Project-specific staff

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Ongoing projects

RESTART project

Understanding the impact of trauma and the benefits of trauma therapy in people at high risk of developing psychosis

Started in 2021, the RESTART project involves work with people vulnerable to psychosis, NHS professionals and international experts to find out whether psychological therapies that specifically target the emotional and psychological consequences of trauma could be useful for improving the mental health of people who are at high risk of developing psychosis.

The first phase of RESTART has involved work in partnership with NHS Trusts in the North West, North East and the Midlands to better understand the impacts of trauma in people at ultra-high risk for psychosis. Building on this work, in 2023 the RESTART team will start the first randomised controlled trial of trauma therapy in people who are at high risk of developing psychosis.

The project will explore if these therapies could be used widely in the NHS, as part of larger-scale research to determine if they could be offered across the UK in the future.

For more information:

• Contact Filippo Varese (Filippo.Varese@manchester.ac.uk)

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The STAR trial

Evaluating whether trauma-focused therapies are helpful for people who experience psychosis 

Many people who experience psychosis have experienced distressing life events both in childhood and adulthood.

Clinicians have been reluctant to offer psychological therapies that target the emotional and psychological consequences of these potentially traumatic experiences. However, recent research has shown that trauma-focused therapies can be safe and helpful for this group.

The STAR Trial is a large clinical trial led by King’s College London and hosted locally by researchers at C-TRU and the GMMH Psychosis Research Unit.

The trial is taking place in five different UK sites, including Greater Manchester, and brings together the clinical and research expertise of the most prominent groups that have conducted trauma therapy research in people with psychosis in the UK.

STAR is evaluating whether a talking therapy called trauma-focused cognitive behavioural therapy for psychosis (TF-CBTp) could help people with psychosis who also experience distressing symptoms of post-traumatic stress disorder (e.g. flashbacks, distressing and vivid memories of traumatic life events, feeling numb and ‘unreal’).

These post-traumatic symptoms are common in people with psychosis, but unfortunately they are often neglected by services. If eligible for the trial, participants will have a 50% chance of receiving nine months of therapy, as well as the opportunity to take part in additional paid studies exploring the impact of this intervention in more detail (for example using neuroimaging methods).

For more information:

• Visit the STAR trial website
• Contact the Manchester STAR team: STAR@gmmh.nhs.uk

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Staff TIME Project

Time to talk about staff trauma in inpatient mental health

Staff who work on acute mental health inpatient wards experience violence, verbal abuse and see patients harming themselves. They also hear about child abuse that patients have experienced in the past. Staff have also told us that racism, homophobia and abuse targeting disabilities happens a lot and can add to other workplace traumas. People from minority groups have said that they had particular difficulties getting support at work.

In this study, we’re interviewing inpatient staff to explore their experiences of working on acute ward. We’ll be recruiting staff from Manchester, Lancashire and South Cumbria, Pennine, Merseyside, London, Somerset, and Cornwall. We’ll be asking what stops staff from seeking or getting support and what is helpful after traumatic incidents or personal abuse on the ward. To make sure we are understanding the needs of all staff, at least half of the people we interview will have a protected characteristic e.g. staff who identify as LGBTQI+, as having a disability or from diverse ethnic communities. We will also make sure we interview people from different professions, age groups and genders.

We are also interviewing people with experience of providing staff support, changing national policy and improving equity, diversity and inclusion within the NHS. We will be asking these stakeholders about their experiences and how we can introduce better staff support in mental health trusts across the UK.

We will use the information from the interviews to make recommendations for how mental health wards can reduce the impact of workplace trauma and increase access to support for all staff. These recommendations will be tested in a future study.

For more information:

• Visit the NIHR page
• Visit the project website
• Contact: study manager Kate Allsopp (Kate.Allsopp@gmmh.nhs.uk) or research assistant Emily Harris (emily.harris2@gmmh.nhs.uk).

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The CONNECT Trial

Can we use digital devices to predict if someone will experience a relapse of psychosis?

People who experience psychosis can encounter changes in their activity levels, sleep patterns and getting out and about just before they become unwell or experience a relapse. For example, someone who is feeling very anxious or low might not feel like socialising much. They might stay at home more than usual, phone their friends less, sleep less and experience other changes. In CONNECT, we want to see how changes in behaviours and patterns might relate to someone’s mental health getting worse. In the future, it might be possible to tell in advance when someone’s mental health might be getting better or worse by looking at these changes and offering extra support at the time it is needed.

For more information:

• Contact Sandra Bucci (sandra.bucci@manchester.ac.uk).
•  
• Website: https://www.connectdigitalstudy.com/

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The ChUSE Trial

Increasing choice in NHS services for children and young people with unusual sensory experiences

The trial is led by Dr Sarah Parry, strategic research lead for our young people’s mental health research centre, through a collaboration between Pennine Care and Greater Manchester Mental Health NHS:

What is the ChUSE trial about?

Distressing sensory experiences, such as hearing voices, seeing visions, or feeling presences others don’t, are often associated with emerging signs of psychosis. These experiences are surrounded by stigma, which can make young people and their parents very anxious. It is this anxiety that often leads young people and families to seek help from children’s mental health services.

Very few of these children will receive a diagnosis of early-onset psychosis, unusual sensory experiences are a common developmental phenomenon, but the anxiety surrounding distressing sensory experiences can cause difficulties for the young person in their day-to-day lives, schooling, and relationships.

Anxiety about distressing sensory experiences can make the symptoms more frightening and harder to ignore, which is why it is so important children and families can access timely support.

Many mental health practitioners feel ill-equipped to offer psychological therapies for distressing sensory experiences due to a lack of national clinical guidelines and child-centred research to inform their approach.

Delayed access to support often increases anxiety further, exacerbates family stress, and often worsens the original symptoms. Parents have explained: “There is a massive gap in services with zero services being available for someone experiencing voices so young”.

Without suitable support, the overall wellbeing of the family can decrease rapidly, reducing their abilities to cope.

For more information:

• Visit the ChUSE website ChUSE trial :: Pennine Care NHS Foundation Trust
• Contact Kyriakos Velemis (kyriakos.velemis@gmmh.nhs.uk) or Sarah Parry (sarah.parry30@nhs.net)

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MIND-P Project

Group mindfulness therapy for individuals with paranoid thoughts

Many people with a diagnosis of schizophrenia experience distressing persecutory delusions (thinking other people are deliberately trying to harm them) and elevated rates of depression.

Talking therapies that include mindfulness, a type of meditation practice, are commonly used to help people with mental health difficulties. In our previous study, we found encouraging signs that mindfulness might be helpful for people with persecutory delusions. We found that 64% of participants showed a reduction in depressive symptoms after finishing the therapy. These findings suggest that mindfulness therapy could be helpful for symptoms of depression, however a larger scale study must be conducted to determine if the therapy will effectively support individuals with schizophrenia.

In this study, half of the participants will receive group mindfulness therapy and their usual clinical care, and the other half will receive their usual care only. All participants will complete questionnaires at baseline, after therapy and at follow up. This will allow us to measure whether the therapy group experience reductions in depression and distress, improvements in psychological health and mindfulness, and greater progress towards recovery.

The MIND-P study is a multisite clinical trial funded by the NIHR and sponsored by the University of Southampton. It is hosted locally by researchers at CTRU. MIND-P will evaluate how the therapy works, who might benefit from it the most and whether it is a good value for money for the NHS.

For more information:

Contact Katherine Berry (katherine.berry@manchester.ac.uk) or Adedamola Falana (adedamola.falana@gmmh.nhs.uk)

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Older adult trauma study

An estimation of the prevalence of Post-Traumatic Stress Disorder (PTSD) symptoms in older adults supported by community mental health services 

 Trauma and psychological difficulties linked to trauma (e.g., PTSD) are highly common among working age adults who suffer from severe mental health problems, however no research to date has replicated these findings in older adult populations.

There are several barriers to recognising trauma in older adults, including stigma; older adults not linking their current difficulties with past traumatic events; and healthcare professionals not recognising their traumas due to diagnostic overshadowing. Given these barriers, it is likely that trauma is under-represented in older adults.

This study, ran by the University of Manchester, assesses adults over 60 years old who are supported by community mental health teams using two assessments: the Trauma and Life Events checklist (TALE; Carr et al., 2018) and the International Trauma Quotian (ITQ; Cloitre et al., 2018). We then screen participants’ clinical notes for any diagnoses and references to trauma before we compare these to our findings from assessment measures.

Our findings will allow us to estimate the prevalence of trauma in older adults under CMHTs which will hopefully inform better access to trauma-focused interventions for older adults. 

For more information: Contact Joshua Barber (joshua.barber@gmmh.nhs.uk)

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Completed projects

IPPACT project

Improving the prediction of severe mental health difficulties in people who are showing early signs of psychosis

Many people who have experienced trauma and distressing life experiences are more likely to develop a range of mental health difficulties, including psychosis.

Psychosis is a mental health problem that causes people to perceive or interpret things differently from those around them. This can involve distressing experiences, such as hearing voices or having unusual beliefs. In the UK, almost half a million people experience psychosis.

Doctors and nurses in the NHS already use special interviews that can identify people who are vulnerable to psychosis. However, the NHS needs better systems to identify people that are at the highest risk of developing severe and distressing psychotic symptoms, and who might benefit from early support before their difficulties worsen and become long-lasting.

The IPPACT project is funded by the NIHR and led by  Dr Filippo Varese, Professor Alison Yung and Professor Sophie Parker (Director of the GMMH Youth Mental Health Research Unit). Started in 2018, this project aims to evaluate the use of a tool that could help NHS clinicians to better identify people who are at the highest risk of developing psychosis

The project involves collaborations with clinical teams based in the North West, North East and the Midlands, and researchers at the GMMH Youth Mental Health Research Unit, Manchester Metropolitan University, The University of Birmingham, The University of Liverpool and The University of Melbourne.

IPPACT will evaluate if it is possible to use this tool in routine NHS settings and whether it could lead to more efficient use of NHS resources to support individuals at high risk of developing psychosis.

For more information:

• Visit the NIHR project page
• Contact project leads: Rebekah Carney (Rebekah.Carney@gmmh.nhs.uk), Heather Law (Heather.Law@gmmh.nhs.uk) or Filippo Varese (Filippo.Varese@manchester.ac.uk) 

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COVID-19 Resilience (Co-Re) project

Understanding the psychological impact of the COVID-19 pandemic on the NHS clinical workforce

The COVID-19 Resilience project was a study to follow-up a large group of NHS staff to find out how their mental health had been affected by the COVID-19 pandemic.

Run in collaboration with researchers and clinicians from various health services and Universities in the North West (e.g. the Greater Manchester Resilience Hub; the Lancashire Traumatic Stress Service; Manchester Metropolitan University), the findings of this project will be used to inform the best ways to support staff wellbeing and mental health and improve their resilience, now and in the future.

For more information:

• Visit the COVID-19 Resilience Project website
• Contact project leads: Kate Allsopp (Kate.Allsopp@gmmh.nhs.uk) or Filippo Varese (Filippo.Varese@manchester.ac.uk)

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Resilience Hubs Evaluation project

Evaluating new NHS services to support key workers whose mental health and wellbeing has suffered as a result of the COVID-19 pandemic

The Resilience Hubs Evaluation was a study funded by the National Institute for Health Research (NIHR). The study ran from October 2020 to May 2021, and its aim was to evaluate four Resilience Hubs in the North of England, services funded by NHS England that were based on a service model originally developed to support those affected by the Manchester Arena Bombing. The model has now been adapted to support the mental health needs of health, social care and other key workers during the COVID-19 pandemic. 

The main objectives of the study were: 

1. To explore keyworker characteristics associated with mental health presentations requiring further support, and explore characteristics associated with lower levels of support access and uptake 
2. To explore what resources were needed to run the Hubs, to understand their ‘value for money’ 
3. To gather a variety of stakeholders’ perspectives on the Hubs, and explore the barriers and enablers to setting up and running the Hubs, and to accessing Hub support. 

In addition to addressing these objectives, we produced a list of recommendations for the Hubs themselves and for the wider health and care system. These are intended to help improve the Hubs’ data collection and communication, improve support access for under-represented groups, and create psychologically safer environments within this system.

Our research supports the Resilience Hub model and demonstrates a need for ongoing mental health and wellbeing support for health and care staff beyond the pandemic. The findings suggest that the Resilience Hubs should continue to provide this valued support, and that this model can be effectively adapted to different contexts, and as a potential system to be repurposed for future responses to other large-scale crises. We are currently working to write up our findings and share these with other staff wellbeing hubs and health and social care organisations across England more broadly. 

 For more information:

• Please contact Kate Allsopp (Kate.Allsopp@gmmh.nhs.uk) or Filippo Varese (Filippo.Varese@manchester.ac.uk)

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Sexual Violence Priority Setting Partnership

Identifying the research priorities of survivors of sexual violence/abuse and the professionals who support them 

Approximately 1 in 10 people in the UK have experienced some form of sexual violence since the age of 16, for example rape, sexual assault or unwanted sexual contact. Furthermore, 1 in 20 children in the UK have suffered from some form of childhood sexual abuse. 

Living with the consequences of sexual violence can have a significant physical and emotional impacts on survivors, but there are several important unknowns around the best way of supporting people who have experienced various forms of sexual violence or abuse. 

The Sexual Violence Priority Setting Partnership was an initiative led by C-TRU and the St Mary’s Hospital Sexual Assault Referral Centre (the oldest and largest service of its kind in the country), and part of the NIHR James Lind Alliance, a non-profit making initiative that brings together people with lived experienced and the professionals who support them in ‘Priority Setting Partnerships’. 

The project is part of the NIHR James Lind Alliance, a non-profit making initiative that brings together people with lived experience and the professionals who support them in Priority Setting Partnerships.

Established in 2020, the Sexual Violence Priority Setting Partnership conducted national surveys to scope the most important unanswered questions in the area of sexual violence and abuse. These were further prioritised by survivors and professionals in a follow-up survey and final collaborative workshops. The main themes for these priorities are as follow: 

1. Support and outcomes which are valued by survivors themselves 
2. The needs of specific survivor groups 
3. The needs of survivors at a broader organisational, and social level 
4. Impacts of involvement in criminal justice proceedings 

Our work suggests that much more research is needed to address the needs of survivors and professionals in this area. Although the Top 10 questions reflect areas that are in most need of research, only 5% of the questions proposed in the first survey were found to be answered by past research. 

The Top 10 can be used as a springboard for improving services offered to survivors of sexual violence, and we encourage survivor representatives to share these priorities and encourage the development of future work. 

 For more information:

• Visit Sexual violence | James Lind Alliance NIHR 
• Contact Project Team: sexualviolencePSP@manchester.ac.uk
• Contact Project Leads: Rabiya Majeed (Majeed@mft.nhs.uk) and Filippo Varese (Filippo.Varese@manchester.ac.uk) 

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EASE trial

Evaluating whether trauma-focused therapies are helpful for people who experience psychosis 

Many people who experience psychosis have experienced distressing life events both in childhood and adulthood. 

Clinicians have been reluctant to offer psychological therapies that target the emotional and psychological consequences of these potentially traumatic experiences. However, recent research has shown that trauma-focused therapies can be safe and helpful for this group. 

This research project worked alongside The STAR Trial, both aimed at evaluating whether these therapies can fill a major gap in the treatment for people with psychosis. 

The EASE trial started at the beginning of 2019. Hosted by Lancashire and South Cumbria NHS Foundation Trust and funded by the NIHR, EASE was a three-year project testing whether it is possible to conduct a future large clinical trial of eye movement desensitisation and reprocessing (EMDR) therapy with people with psychosis who are supported by early intervention services in the UK. 

The study involved collaborations with researchers from the Universities of Sheffield and Lancaster, and EMDR experts based at the Lancashire Traumatic Stress Service.

The project was successfully completed in May 2022, with promising findings suggesting that EMDR should be investigated further in larger scale trials with clients with early psychosis.

You can view the published results here: Trauma-focused therapy in early psychosis: results of a feasibility randomized controlled trial of EMDR for psychosis (EMDRp) in early intervention settings | Psychological Medicine | Cambridge Core

For more information:

• Contact Filippo Varese (Filippo.Varese@manchester.ac.uk)

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Staff TIME Project

Time to talk about staff trauma in inpatient mental health

Staff who work on acute mental health inpatient wards experience violence, verbal abuse and see patients harming themselves. They also hear about child abuse that patients have experienced in the past. Staff have also told us that racism, homophobia and abuse targeting disabilities happens a lot and can add to other workplace traumas. People from minority groups have said that they had particular difficulties getting support at work.

In this study, we’re interviewing inpatient staff to explore their experiences of working on acute ward. We’ll be recruiting staff from Manchester, Lancashire and South Cumbria, Pennine, Merseyside, London, Somerset, and Cornwall. We’ll be asking what stops staff from seeking or getting support and what is helpful after traumatic incidents or personal abuse on the ward. To make sure we are understanding the needs of all staff, at least half of the people we interview will have a protected characteristic e.g. staff who identify as LGBTQI+, as having a disability or from diverse ethnic communities. We will also make sure we interview people from different professions, age groups and genders.

We are also interviewing people with experience of providing staff support, changing national policy and improving equity, diversity and inclusion within the NHS. We will be asking these stakeholders about their experiences and how we can introduce better staff support in mental health trusts across the UK.

We will use the information from the interviews to make recommendations for how mental health wards can reduce the impact of workplace trauma and increase access to support for all staff. These recommendations will be tested in a future study.

For more information:

• Visit the NIHR page
• Visit the project website
• Contact: study manager Kate Allsopp (Kate.Allsopp@gmmh.nhs.uk) or research assistant Emily Harris (emily.harris2@gmmh.nhs.uk).

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I-Minds

Developing and testing a new digital resource for young people who have experienced technology

Technology–assisted sexual abuse has increased in recent years, especially during the COVID-19 pandemic. However, there is little tried and tested support for young people who have experienced this. The NHS urgently needs an accessible intervention to improve the wellbeing of young people who have experienced technology-assisted sexual abuse and that could protect them from future harm.

Started in 2021, we worked with young people who have experienced technology-assisted sexual abuse, parents and caregivers and relevant services in Manchester and Edinburgh to develop and test a digital intervention to improve wellbeing and reduce the risk of re-victimsation and harm.

Informed by mentalisation theory, we developed a digital health intervention in the form of an app to support young people who have experienced technology-assisted sexual abuse. The app was then tested with young people over a 6-week period. We also spoke to young people and professionals about their views on a digital intervention in this area, and how it could be implemented in services.

The project was successfully completed in 2023. We are currently preparing the findings of the study for publication and dissemination.

For more information:

• Sandra Bucci (Bucci@manchester.ac.uk); Filippo Varese (Filippo.varese@manchester.ac.uk).

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Talk, understand, listen for inpatient settings (TULIPS) project

Increasing access to psychological therapy on mental health inpatient wards

TULIPS started in 2018 and will come to an end in spring 2024. This research project aimed at increasing access to psychological therapy on inpatient mental health wards by designing a psychological service model in collaboration with service users and service providers. Subsequently, we tested the developed intervention in 34 acute mental health wards across the UK. We hope that the intervention has a positive effect on the wellbeing of the people using services in acute mental health wards and the number of serious incidents in these settings.

For more information:

• Visit the TULIPS project website
• Email Project Manager Helen Wilson: Helen.wilson@manchester.ac.uk or Project Manager Fritz Handerer: Fritz.handerer@gmmh.nhs.uk 

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